Intrarenal resistance index for the assessment of early renal function impairment in patients with liver cirrhosis.
BACKGROUND
Renovascular vasoconstriction in patients with hepatorenal syndrome can be quantified by the renal arterial resistance index (RI). We investigated the value of RI measurement in detection of renal function impairment in patients with different stages of chronic liver disease.


METHODS
Subjects were divided into 4 groups containing 21 patients with liver cirrhosis and ascites, 25 patients with liver cirrhosis without ascites, 35 patients with fatty liver disease and 78 control subjects. All patients underwent abdominal ultrasound examination with renal RI measurement and correlation with laboratory results for renal function.


RESULTS
RI was significantly higher in ascitic patients compared to non-ascitic patients (0.74 vs. 0.67, p<0.01) and in non-ascitic patients with liver cirrhosis than in control subjects (0.67 vs. 0.62, p<0.01). 48% (19/40) of patients with liver cirrhosis and normal serum creatinine concentration showed elevated RI levels. There were no significant differences in RI levels between patients with fatty liver disease and controls (0.63 vs. 0.62).


CONCLUSIONS
Intrarenal RI measurement is a predictor of renal vasoconstriction and serves to detect early renal function impairment in cirrhotic patients. The diagnosis of elevated RI may be taken into account in the clinical management of these patients.
Götzberger
M
M
Klinikum der Universität München, Medizinische Klinik-Campus Innenstadt, Ziemssenstr. 1, 80336 München, Germany. manuela.goetzberger@med.uni-muenchen.de
Kaiser
C
C
Landauer
N
N
Dieterle
C
C
Heldwein
W
W
Schiemann
U
U
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005234:Fatty Liver / Q000175:diagnosis; D005260:Female; D005355:Fibrosis; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018608:Ultrasonography, Doppler / Q000379:methods; D014662:Vasoconstrictor Agents / Q000494:pharmacology
D014662:Vasoconstrictor Agents